A Heroic Rural Doctor in remote West Virginia

We reached the furthest point on our journey last weekend when we visited a person who had become very close to us over the last two years, but whom we had never met. We were introduced to this remarkable person, Dr. Susan Schmitt, by my brother Leon. Leon and his wife Lucy are avid folk-dancers, with a passion for contra dance. Every year they escape from the Eastern winter to dance with a convivial group on St Croix in the Caribbean. To my good fortune one of the couples who shares in this winter migration are Susan Schmitt and Doug Wagner, from Thomas, West Virginia.

When Leon visited me about three months after my abrupt and catastrophic encounter with a rare abdominal sarcoma called a GIST, he told me that that one of his dancing partners, a rural doctor in West Virginia, shared this unusual diagnosis. More remarkably, she was still vigorously alive, working as a solo rural family doc, and clicking her heels in St Croix five years after emergency surgery for the same condition. Although I initially thought he probably had misunderstood what she told him, when I was struggling with the side-effects of the chemotherapy for this rare cancer, I got Susan’s number from Leon and called her.

This was the beginning of a phone and e-mail friendship between two intense family doctors grappling with the reality of a bad disease, the side-effects of powerful medicine, and the various disruptions resulting from the fairly heroic surgery that had saved our lives, but altered both our anatomy and physiology. Each of us had discovered different strategies for coping with the disease, and the emotional and physical challenges that come with cancer and its treatment. We shared our discoveries with each other, used each other for informal consultations as new symptoms would crop up, and became a powerful two-person cancer support group.

Thus when this road trip progressed from fantasy to a concrete plan, visiting Susan in West Virginia became the compass pole around which we designed our journey. So our furthest point from Seattle became Susan and Doug’s majestic house on Backbone Mountain just outside of Thomas.

As part of the visit we visited Susan in her half-time solo practice in Parsons, a struggling town that was almost wiped from the map during the flood of 1985. Susan has a devoted following in the town, but the economics of rural medicine in West Virginia are so challenging that the practice works only because Doug is her volunteer receptionist and book-keeper, while both of them share some of the janitorial duties. The other half of her practice is in an other small town a perilous hour and half drive from her home, plus stints of taking call at a Critical Access Hospital in yet another small town.

Susan has also experienced some of the vicious politics of rural West Virginia, including a vendetta that led to her being fired from a health center that she helped to create at the same time she was dealing with the challenges of trying to survive a lethal disease. Not only did she lose her health insurance – the chemotherapy that has kept both of us alive costs thousands of a dollars a month – but she was slapped with bogus criminal charges. She fought back vigorously and successfully, being completely exonerated of the trumped-up charges. Fortunately, she had enormous support from her patients and some segments of the professional community, and soon returned to what she loves and does best – taking care of sick people in West Virginia. Not only does she take care of disease, but she is committed to trying to prevent the enormous toll that obesity and diabetes take in West Virginia, and started a Wellness Center in Parsons that has since been adopted and supported by the city.

Although Susan and I had never met before this trip, we felt like we had known each other for years. Her example, her fortitude, and her fierce embrace of life have helped me enormously over the last two years. Her husband Doug and my wife Fernne share the ability to sustain us without draining of us our fierce uncompromising independence. It was a powerful weekend.